ASPAN "retired" the position statement that said "It is, therefore, the position of ASPAN that two registered nurses, one competent in Phase I postanesthesia nursing, will be in the same unit where the patient is receiving Phase I level of care at all times " (ASPAN, Approval Statement 2, 1998 updated 2009, retired 2012) http://www.aspan.org/Portals/6/docs/...ffing_2012.pdf
The newest recommendation that was approved in 2016 states "Physical capacity of the unit to meet 1:1 admission criteria, preventOR delays and allow for additional resources to assist with adverse events (e g , delirium, agitation, respiratory events, cardiac events, hemodynamic instability, excessive pain, desaturation, hypoxia, hyperthermia)" (ASPAN Position Statement 14, 2016) http://www.aspan.org/Portals/6/docs/...-13-101227-450
I'm not sure why ASPAN changed their position, in the statement it states that the old statement was interpreted differently all the time and the recommendations weren't followed due to budgets and difficulty predicting staffing needs. It also says that ASPAN receives a call at least weekly asking about these recommendations. So along with the above statement it gave 12 other consideration regarding staffing. You can find them in the above link. But the practice standard has remained the same.
Practice Statement 1 ( newest in 2015) states "Two Registered Nurses, one of whom is an RN competent in phase I postanesthesia nursing, are in the same room/unit where the patient is receiving phase I level of care.c These staffing recommendations should be maintained during “on call” situations.”
We too use the OR nurse as backup when on call. All most all will ask if they need to stay, sometimes they ask after they have already changed into street clothes, which send the obvious message they don't want to. They all do wait to come in and check and ask after they have finished in the OR. This means their paperwork is complete, and everything has been cleaned and the OR ready for the next patient. If we have multiple call cases back to back, I don't ever see the OR nurse and I'm hoping that I get my first patient recovered and to the floor before the next one rolls in. There have been times I worried about that and texted our team and asked if someone was available to come and help (my manager has never told us to stop doing that, and normally someone comes right in to help, but since they are not on call you are at the mercy of if and when they check their phones).
If I am super concerned about a patient I will ask the anesthesiologist to stay for a bit, if it's a teen/young adult male... I get the orderly or security to come and get my through the emergence delirium.
So I definitely hear those concerns and feel the same.